[Experience with Dohlman-Doane keratoprosthesis: case reports]

Arq Bras Oftalmol. 2008 Mar-Apr;71(2):257-61. doi: 10.1590/s0004-27492008000200023.
[Article in Portuguese]

Abstract

Purpose: To describe 9 eyes in 8 patients who received Dohlman-Doane type 1 keratoprosthesis (KPro) with a mean follow-up of 11.2 months (2 to 25 months).

Methods: A retrospective, non-comparative interventional case series. Previous corneal disease was alcaline burn in 4 eyes, multiple graft failure in 3 eyes, Stevens-Johnson syndrome in 1 eye and thermal injury in 1 eye. Best corrected visual acuity (BCVA) was hand motions or worse in all patients. Glaucoma was present preoperatively in 3 eyes and received Ahmed valve implantation.

Results: 88,9% eyes achieved BCVA of better than or equal to 20/100, and 44,4% better than or equal to 20/40. In the postoperative period, 3 eyes developed posterior capsule opacity treated with YAG laser capsulotomy; 3 retroprosthetic membrane treated with tPA injection or steroids; 2 glaucoma in clinical treatment; 1 corneal melting, treated with donor cornea bottom exchange; and 1 fungic endophthalmitis, treated with corneal transplant, anterior vitrectomy, KPro and intraocular lens explantation, and specific intravitreal and endovenous treatment.

Conclusion: Dohlman-Doane K-Pro seems to be a good option for cases of corneal blindness with poor prognosis for traditional penetrating keratoplasty. Its main advantage is not requesting systemic immunossuppression. Best results were achieved in non-immune diseases.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Blindness / surgery
  • Corneal Diseases / surgery*
  • Corneal Opacity / etiology
  • Corneal Transplantation / adverse effects
  • Corneal Transplantation / methods*
  • Eye Burns / surgery
  • Female
  • Follow-Up Studies
  • Glaucoma / etiology
  • Graft Rejection / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Preoperative Care
  • Retrospective Studies
  • Visual Acuity / physiology
  • Young Adult